John Feldman – Founder of Applied Pathways

John Feldman has spent over 25 years in healthcare. His work has revolved around building young companies with information products and services designed for health care consumers and professionals.

Prior to founding Applied Pathways, he has participated in the launch and growth of several innovative and some highly successful healthcare companies including Consumer Health Services which offered Prologue, America’s Most Complete Information Source on Doctors, Access Health (Ask-A-Nurse), Informed Access Systems, Careinsite and WebMD. Mr. Feldman’s roles have included product development, sales, marketing, strategy and business development in companies that have variously served payers, providers, publishers, HIT vendors and pharma. Mr. Feldman received his B.A. degree from the University of Colorado.

0:00 Founder of Applied Pathways, a clinical decision support tool. John’s journey started working for a pre-WebMD company, where he helped developed the first commercial application of nurse triage, in order to limit unnecessary use of emergency room services.

2:00 In 1992 the approach to care was less about standardization and more about bringing an engineering approach to a clinical domain. Objective was to create a highly reproducible process.

2:45 John moves over to Care Insight for five years, which eventually merged with WebMD.

4:00 John decides to pursue his own business in Applied Pathways.

7:00 What is clinical decision support? It spans a continuum of ideas from turning data analytics into knowledge. Applied Pathways is concerned with how that knowledge is then delivered.

8:00 Data readers “produce knowledge” which can then be turned into an “executable algorithm” using Applied Pathways that can then be integrated into EMRs or any electronic clinical information system.

8:15 Applied Pathways works within the clinical decision support realm of engineering clinical process improvement.

10:00 Applied Pathways is purely the technology; they stay content neutral. Users will develop or promote a guideline, which Applied Pathways then turns into something executable.

11:30 Domain expertise in healthcare tends to be within the medical specialty societies, which want to make sure that their guidelines are propagated.

12:20 Health systems will pick guidelines that payers and providers then agree to adhere to; the standard of healthcare in Minnesota is decided by an organization that picks the state’s guidelines in this way.

14:25 The nature of value-based reimbursement is forcing health-systems to understand their costs in order to thrive. This is where domain experts come into play to define the best practice.

15:30 How configuring a work-flow is important to this practice.

16:50 Applied Pathways provides a solution to the problem of standardizing health records and guidelines for practice between providers.

17:20 Applied Pathways’ clinical decision support tool technology is a “rules-modeling” environment that allows clinicians to model the rules without needing to know how to program.

18:00 Applied Pathways technology allows them to extract data from EMRs and process that data and return some sort of message back to the EMR.

19:10 How healthcare systems use Applied Pathways to standardize their practice.

23:45 The future of healthcare utilization management is moving from a retrospective model to a prior authorization model.

25:00 The point of this is to make sure that physicians are clear on what the evidence-based medicine would suggest the best treatment is.

25:30 Clinical decision support may not be impactful in the immediate future on the physician, but will help relieve some of the payment pressures for healthcare providers.

26:30 The purpose of clinical decision support extends past clinicians in its ability to simplify care plan information for patients and other medical staff.

27:00 Applied Pathways’ impact on quick innovation; its ability to bring light to new medicines and treatments.

28:00 How resource innovation and Healthcare IT play into the quality of medicine.

29:00 “Turning knowledge into software is a problem that is pandemic.”

29:25 Applied Pathways allows domain experts to work directly with technology without needing to know how to “model the rules,” in order to prevent as much human error as possible on the side of the computer programming.

30:13 “We’re kind of a compliment to content management.”

30:30 What all of this boils down to: Applied Pathways allows clinicians to use and mold clinical guidelines in the ways that best suit them.

32:15 Applied Pathways was built with the idea of a cloud-based exchange to propagate best practices.

34:40 How Applied Pathways affects the Pharmaceutical world.

36:30 How this technology is going to impact different brands and products within the healthcare and pharmaceutical industry.

37:45 How pharmaceutical marketing will need to change with the growth of this guidelines-based clinical decision support process.